It’s that time of year, when winter has finally heaved its last frigid breath and exited the building. We all look forward to Springing Ahead with warmer days, later sunsets and walks through the park. The change in seasons is also marked with a switch in outfits as we exchange heavy down coats for lightweight jackets, and boots for flip-flops.
It is often around this time that we PT’s see a gradual increase of patients complaining about heel pain. The onset is usually sudden with no traumatic injury, and patients are shocked that their first step out of bed in the morning is now painful. Pain quickly resolves after a short walk or with stretching, but the next morning is often a repeat performance. These are the hallmarks of plantar fascitis: painful walking in the morning and a point-specific tenderness around the heel.
Theoretically, this change happens in women who often wear high heels and then suddenly switch to wearing a shoe with a very low heel or no heel at all, as with flip-flops. The plantar fascia, a thick sheet of connective tissue on the underside of the foot, may get tight over time due to the positioning of the foot while in heels. The abrupt change in footwear (coupled with walking on hard city sidewalks) puts a strain on the fascia and its connection to the heel, resulting in inflammation and pain.
How can we avoid this? It’s not realistic to ask patients to give up their collection of high heeled shoes or to wear clunky orthotic shoes in the height of summer, but we can prepare for the change in footwear. A simple stretch of the calves, which is comprised of two different muscles, can help to reduce tightness through the back of the lower leg. (See images below) Secondly, Towel Scrunches are a simple exercise to strengthen the short muscles of the underside of the foot, and may help to relieve some of the strain on the plantar fascia. (See images below)
Sometimes, however, the pain may persist. It’s then a good time to visit your podiatrist or trusted physical therapist for an evaluation and treatment. As a PT, we will evaluate the mechanics of your foot, ankle and entire leg, and perform a gait analysis. Along with skilled manual therapy, strengthening exercises and a home program, you should be well on your way to walking without pain.
If you are experiencing these symptoms, it may be time to stop wishing it away - come in and let’s get started! Springtime should enjoyed, with a (pain free) spring in your step!
Mark M Lusk, DPT, OCS, CFMT